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Vitamin D analogue therapy, cardiovascular risk and kidney function in people with Type 1 diabetes mellitus and diabetic nephropathy: a randomized trial
Author(s) -
Joergensen C.,
Tarnow L.,
Goetze J. P.,
Rossing P.
Publication year - 2015
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12606
Subject(s) - medicine , renal function , endocrinology , urology , diabetic nephropathy , diabetes mellitus , nephropathy , placebo , filtration fraction , microalbuminuria , excretion , renal blood flow , alternative medicine , pathology
Aim To evaluate the effects of therapy with the vitamin D analogue paricalcitol on markers of cardiovascular risk and kidney function in people with Type 1 diabetes mellitus and diabetic nephropathy. Methods In a double‐blind, randomized placebo‐controlled, crossover trial, 48 participants on stable renin angiotensin aldosterone system blockade and diuretics were assigned, in random order, to 12 weeks of paricalcitol and 12 weeks of placebo therapy, separated by a 4‐week washout period. Primary and secondary endpoints were changes in plasma N‐terminal probrain natriuretic peptide and urinary albumin excretion rate obtained before and after each intervention. Glomerular filtration rates were estimated and measured ( 51 Cr‐ EDTA plasma clearance glomerular filtration rate) after each intervention. Results The mean ( sd ) age of the participants was 57 (9) years, the baseline geometric mean (95% CI ) urinary albumin excretion rate was 148 (85–259) mg/24 h, the mean ( sd ) HbA 1c was 70 (9) mmol/mol [8.6 (3)%], the mean ( sd ) estimated glomerular filtration rate was 47 (15) ml/min/1.73 m 2 and the mean ( sd ) 24‐h blood pressure was 135 (17)/74 (10) mmHg. Compared with placebo therapy, vitamin D analogue therapy had no significant effect on plasma N‐terminal probrain natriuretic peptide concentration ( P = 0.6), urinary albumin excretion rate was reduced by 18% ( P = 0.03 for comparison), estimated glomerular filtration rate was reduced by 5 ml/min/1.73 m 2 ( P < 0.001) and measured glomerular filtration rate was reduced by 1.5 ml/min/1.73 m 2 ( P = 0.2). Conclusions Paricalcitol therapy did not affect plasma N‐terminal probrain natriuretic peptide concentration in people with Type 1 diabetes and diabetic nephropathy; however, the urinary albumin excretion rate was significantly lowered.